Diabetes: Nerve Damage (Neuropathy)

The most common form of diabetic neuropathy
is loss of feeling in the hands and feet. It is called
peripheral neuropathy.

Diabetic neuropathy can also affect the
nerves that control body functions such as heart rate and
digestion. This type of problem is called autonomic
neuropathy.

How does it occur?

Doctors have been studying this problem for
many years, but they do not yet understand how diabetes
damages the nervous system. However, they do know that good
control of blood sugar levels helps prevent diabetic
neuropathy.

What are the symptoms?

You may not be aware of any symptoms of
peripheral neuropathy. If you do have symptoms, they may
include:

numbness and loss of feeling (usually
first in the feet or hands)

slower reflexes

pain ranging from minor discomfort or
tingling in fingers and toes to severe pain

pain that is sharp or lightninglike

pain that is a deep ache that makes
sleep or daily activities difficult

painful sensitivity to the slightest
touch

weak muscles.

The symptoms of autonomic neuropathy
include:

low blood pressure and dizziness when
you rise quickly from sitting or lying down

rapid or irregular heartbeats

constipation or diarrhea

nausea or vomiting

trouble swallowing

trouble having an erection.

How is it treated?

There is no treatment for neuropathy. The
best approach is prevention by controlling your blood sugar.

Muscle weakness is treated with support,
such as splints. Physical therapy can help with exercises
for the weak muscles. Exercises can be also used to
strengthen other muscles that have not weakened.

Pain-killing drugs or cream applied to the
skin may help pain during the night. Medicines can be used
to treat nausea, vomiting, and diarrhea.

If you have diabetic neuropathy, injuries
are a serious problem because you can't feel if something is
hot or sharp. The diabetes also makes it harder for injuries
to heal. It is very important to be extra careful to avoid
burns, cuts, and other injuries.

How long will the effects last?

The neuropathy will continue once you have
it. However, you may be able to stop it from getting worse
by keeping your blood sugar under good control.

How can I take care of myself?

Neuropathy makes other diabetes-related
complications worse. For example, if you have lost feeling
in your feet and legs, you may not know you have an injury
or infection until it develops into a bad sore. Make sure
you:

Look for injuries on the skin of your
feet and lower legs daily.

See your provider promptly if you have
redness, bumps, blisters, or sores on your skin so they
can be treated properly.

See your health care provider or a
podiatrist about corns or calluses on your feet.

Ask your provider about how to trim your
toenails properly.

Wear good-fitting, comfortable shoes
that protect your feet.

Men who have trouble having erections, which
is a condition called erectile dysfunction, or ED, should
talk to their health care providers. There are medicines to
help a man achieve and maintain an erection. There are also
mechanical devices to help. Ask your provider if your
problem is related to the diabetes and what might be done
about it. Urologists are the specialists who usually help
with ED.

How can I help prevent diabetic
neuropathy?

The best way to help prevent diabetic
neuropathy is to:

Control your diabetes. Try to keep your
blood sugar at a normal level.